Bladder CA: Epidemiology & Diagnosis

 Bladder CA: Epidemiology & Diagnosis

It is the 6 th most common cancer and one of the most expensive cancers to treat

Risk Factors: Elderly male / smoking / environmental (arsenic) and occupations exposure (aniline dyes) / medications like cyclophosphamide

Mortality has reduced due to :

1. Advances in diagnosing bladder cancer

2. Advances in treatment

Histopathology:

1. 90 % bladder cancers are urothelial cancers 

                   - variety of histologic variants

                   - High grade and locally advanced

                   - Micropapillary / plastacytoid / sarcomatoid variants are 

                      most aggressive

2. 6 - 8 % are squamous cell ca

3. 2 % are adenocarcinomas (1/3 rd are urachal in  origin)

Clinical presentation: hematuria

Diagnostic Work up: 

1. Gross Hematuria: CT Urography + Cystoscopy

2. Microscopic Hematuria 

- Low risk: Repeat urinalysis in 6 months or CT ultrasound + Cystoscopy

- Moderate risk: Ultrasound + Cystoscopy

- High risk: CT Urography + Cystoscopy

Urine Cytology: Considered in /initial work up if suspicion of cancer is high

Confirmation: Direct visualization with cystoscopy and transurethral resection of bladder tumor (TURBT)

Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003397/

Prepared by Dr. Sharad Maheshwari

24.03.2023

Updated: